Provider Demographics
NPI:1639692569
Name:FRAMEWORK PHYSICAL THERAPY AND DANCE MEDICINE, INC
Entity Type:Organization
Organization Name:FRAMEWORK PHYSICAL THERAPY AND DANCE MEDICINE, INC
Other - Org Name:FRAMEWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:IMRISEK
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:213-444-3781
Mailing Address - Street 1:8391 BEVERLY BLVD # 596
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2633
Mailing Address - Country:US
Mailing Address - Phone:213-444-3781
Mailing Address - Fax:
Practice Address - Street 1:1350 N HIGHLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7905
Practice Address - Country:US
Practice Address - Phone:213-444-3781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38172261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy